Monday, June 04, 2007
TB case: Could you have done the same?
"Mom, I really don't want to go. I'm so itchy," I whined.
"You have to go. That's the plan. Your aunt is expecting you," my mother told me as she wrapped a scarf around my neck and put sunglasses on my little head to cover up the marks. I was 8 years old.
"But I'm not allowed on the airplane with chicken pox. If I had school, I wouldn't be allowed to go there," I pressed.
"You'll be fine. Just don't talk about chicken pox," my mother commanded as she nudged me on that plane alone headed toward Mississippi for summer vacation.
For good or bad, my childhood experience has made me question how differently I would have acted had I been in Andrew Speaker's shoes.
For sure, tuberculosis and chicken pox are very different. Just a few facts on your average tuberculosis (less serious than Speaker's "extensively drug-resistant," or XDR-TB): About a third of the world's population is infected with tuberculosis and most cases are latent, or not active.
Tuberculosis kills approximately 1.6 million people a year. The bacteria take over your body and keep it from functioning properly. "It's been called consumption because people literally waste away. You end up looking like a concentration camp victim," says Dr. Max Pomerantz, a TB expert and surgeon at University of Colorado at Denver Health Sciences Center.
Each person with tuberculosis infects 10 to 15 other people, usually by coughing germs into the air, according to the World Health Organization. Once inside a new host, TB develops in 5 percent to 10 percent of healthy people. In the remaining people it can be carried around for years or decades without causing any symptoms. The dormant TB can be triggered to activity by a disruption in the immune system.
To be clear, extensively XDR-TB is no more virulent or contagious than non-resistant tuberculosis. It's more dangerous because it does not respond to some of the strongest antibiotic treatments in existence. It's very difficult and very expensive to treat. Andrew Speaker faces a two-year course of treatment and his doctors in Denver approximate it will cost at least $250,000 to $350,000 for his care at National Jewish Medical Center.
So armed with all that information, I'd like to say that I wouldn't have tried to get on a plane home after authorities warned me I was a health risk, but to be honest I'm not absolutely certain. Speaker apologized to his fellow passengers on "Good Morning America" on ABC: "I don't expect those people to ever forgive me. I just hope they understand that I truly never meant them any harm."
How would you have acted? Would you have stayed in a foreign country's hospital after being warned? If you didn't have symptoms, would you have believed you were a public health threat? Do you think Andrew Speaker should be held liable? Do you have more questions about tuberculosis? Do you think the TB case merited so much media attention?
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